2.3 Developmental Assessment - Infants

Question 1

FYI
The leading causes of infant mortality in 2016 were congeni-
tal malformations, low birth weight and prematurity, maternal

delivery complications, sudden infant death syndrome, and unin-
tentional injuries

Question 2

What is the fold standard for tracking infant growth

Answer 2

WHO growth charts from birth to 24 months

The WHO used breastfed infants to establish the
growth norm and provided a better description of physiological growth in infancy.

Question 3

What is the average weight gained per week from 0-6 months of age

Answer 3

150-210g (5-7oz)

Question 4

By 6 months of life the infants weight should be what

Answer 4

double birth weight

Question 5

By 1 year old the infants weight should what

Answer 5

be triple the birth weight

Question 6

How much does the length of an infant increase each month from 0-6 months

Answer 6

2.5cm (1”)

slows after first 6 months of life

Question 7

How does weight gain compare to length growth

Answer 7

weight gain is steady and gradual

length increases occur in sudden spurts

Question 8

By one year old the infants length should increase by

Answer 8

50% increase from birth length

Question 9

In the first year does the length increase come from the legs or trunk growth

Answer 9

truncal growth

Question 10

During the first 6 months of life how much does HC increase by each month

Answer 10

head circumference increases by 1.5cm per month for first 6 months

Question 11

How much does HC increase by each month during 6months-1year

Answer 11

slows to 0.5cm per month

Question 12

At one year how much has the HC increased from birth

Answer 12

33%

during this time crainial sutures also close

Question 13

When does the posterior fontanel close

Answer 13

between 6-8 weeks of age

Question 14

When does the anterior fontanel close

Answer 14

around 14 months old

range of 2-18 months

Question 15

How much does the size of the brain increase during the first year old life

Answer 15

increases 2.5 times the size from birth

Question 16

At birth what is the size difference between the chest circumference and head circumference

Answer 16

chest is ~2cm smaller than head

Question 17

At one year old how does the chest circumference size compare to the HC

Answer 17

equal

During this time, the chest lateral diameter becomes larger than the anteroposterior diameter

Question 18

What is the average RR for infants

Infants use their diaphragms to breathe but abdominal respiratory movements are normal.

Answer 18

30-50 breaths / min

Question 19

What is the average HR for infants

Answer 19

80-160/min

Question 20

What is a normal variation for infants regarding cardiac rhythm

Answer 20

sinus arrhythmias are common causing increased HR during inspiration and decreased HR during expiration

Question 21

What do typical stools look like for infants

Answer 21

yellow cottage cheese soft

esp breastfed

Question 22

What do infant stools like like by the time they’re 1 year old

Answer 22

the passage of incomplete solid food, such as corn and peas, in
the stool.

By the end of the first year, the infant’s stools decrease to one to two a day instead of the more frequent movements that
occur in the first few months.

Question 23

turn table 10.1 page 94 into chart for developmental and growth milestones in infants

Question 24

turn page 100 table 10.2 into cue cards for screening tools for developmental milestones for infants

Question 25

What is a normal amount of crying for an infant

Answer 25

5-6 hours a day

Question 26

When does the normal developmental fussy period start and end

Answer 26

starts at 2 weeks and can continue until 3-5 months old

crying starts and stops for no reason and is unrelated to anything the parent doses

Question 27

What does vigorous and lusty crying indicate

Answer 27

healthy infant

Question 28

What does high-pitched shrieking crying indicate

Answer 28

Associated with central nervous system issues or genetic syndromes.

Examples:
- cornelia de lange syndrome (Cry resembles a sheep bleating, often linked to severe developmental delay)
- Cri-du-chat Syndrome: Named for its characteristic cry, which resembles a cat meowing. This is a chromosomal disorder caused by a deletion on chromosome 5.
- Cerebral Irritability: High-pitched cries may signal conditions like meningitis, where brain inflammation affects neurological function

Question 29

What does grunting crying indicate

2

Answer 29

sepsis
resp distress

Question 30

What does a hoarse cry indicate

Answer 30

hypothyroidism

Question 31

What does a stridorous cry indicate

3

Answer 31

• infection (croup, epiglottis)
• treacheal abnormalities
• foreign body

Question 32

What does a weak cry indicate

Answer 32

muscle weakness (muscular dystrophy, MG)

Question 33

What is colic

Answer 33

excessive crying for more than 3 hours per day for more than 3 weeks in infants 1-4 months old

this is a TYPICAL infant behaviour- it is not a medical dx

When difficult-to-soothe crying occurs, a careful history and physical examination including a thorough gastrointestinal and neurological assessment should be performed.

If the infant is gaining weight appropriately and has a normal physical examination, laboratory and radiographic studies are unnecessary.

The main management is an acknowledgement by the provider of the tre mendous difficulties the parents are dealing with and an inquiry about the well-being of the parents.

There is no evidence to support changing formulas or using medications to manage crying.

Herbal teas and supplements should be used with caution because of lack of standardization of strength and inadequate data to inform dosing.

Question 34

What is The Period of PURPLE Crying Initiative

Answer 34

resource for parents to assist them during the developmentally normal fussy period.

The term PURPLE is an acronym that is used to describe specific characteristics of an infant’s cry during this period and provides parents with knowledge that this is indeed normal and will pass in time

Question 35

What can be done to help infants with excessive crying

Answer 35

white noise to calm, car rides

Discourage parents from putting the infant in a car
seat on the dryer or using a blow dryer, in order to prevent falls and burns.

Question 36

The following are risk factors for developmental delay disabilties in infants:

• maternal ___ during pregnancy
• genetics like ___, ___, ___
• Maternal ____ during pregnancy
• low birth ____
• family history of ____
• infants who required _____
• birth ____

Answer 36

• maternal infections during pregnancy (like CMV)
• genetics like angelman, fragile X, prader-willi syndrome
• Maternal substance use during pregnancy (smoking, alcohol, legal and illegal drugs)
• low birth weight
• family history of developmental disorders esp siblings
• infants who required NICU
• birth trauma

Question 37

Make cue cards for chart on page107 table 10.4 red flags for newborns and infants